You can help us be prepared for your visit by completing the relevant patient forms and bringing them with you to the initial visit.
Not all forms are required for all patients. If you have any questions, please call and we will be happy to assist you.
| Adult Registration Forms (Adults, 19 years and older) Click for a printable version |
|
| Minor Registration Forms (Children up to age 18-years of age) Click for a printable version |
|
| HIPPA Notice of Privacy Practices (All patients must complete) Click for a printable version |
|
| Medical Records Request Authorization (If you would like one of your doctors to share your medical records with Center For Cough) Click for a printable version |
|
| Medical Records Release Authorization (If you would like Center For Cough to share your record with another one of your doctors) Click for a printable version |
|
| Map and Directions Click for a printable version |